AIM: To evaluate the efficacy and safety of orbital decomposition (OD) surgery in combination with horse chestnut seed extract (HCSE), as compared to OD atone, in patients with thyroid-associated ophthalmopathy ...AIM: To evaluate the efficacy and safety of orbital decomposition (OD) surgery in combination with horse chestnut seed extract (HCSE), as compared to OD atone, in patients with thyroid-associated ophthalmopathy (TAO). METHODS: Sixty-two orbits from 62 TAO patients were randomly assigned to OD or OD+HCSE at 1:1 ratio (31 received OD alone, 31 received OD +HCSE). Forty-two orbits from 21 healthy subjects were used as controls. Complete ophthalmic examination and color Doppler flow imaging (CDFI) were performed before surgery and 3mo post-surgery on all 62 orbits from the TAO patients. CDFI were also performed on the 42 control orbits, The effect of OD +HCSE and OD alone on TAO orbits was compared on several endpoints, including superior ophthalmic vein blood flow (SOVBF) parameters, subjective assessment, soft tissue involvement, lid retraction, diplopia, eye movement restriction, degree of exophthalmos, and intraocular pressure. The control orbits were used as reference for the SOVBF parameters. RESULTS: OD surgery with or without HCSE improved SOVBF, symptoms and soft tissue involvement, decreased degree of exophthalmos and intraocular pressure in orbits of TAO patients. The OD +HCSE combination led to significantly better improvement of SOVBF than OD alone. The differences between the reductions of SOVBF in the two groups are 1.26 cmls in max-volecity and 0.52 cm/s in min-voiecity (P〈0.0001). CONCLUSION: SOVBF is significantly reduced in the orbits affected with TAO, indicating that congestion may be an important factor contributing to TAO pathogenesis. OD surgery improves the SOVBF, and combination of HCSE medication and OD surgery further improved venous return than OD surgery alone.展开更多
文摘AIM: To evaluate the efficacy and safety of orbital decomposition (OD) surgery in combination with horse chestnut seed extract (HCSE), as compared to OD atone, in patients with thyroid-associated ophthalmopathy (TAO). METHODS: Sixty-two orbits from 62 TAO patients were randomly assigned to OD or OD+HCSE at 1:1 ratio (31 received OD alone, 31 received OD +HCSE). Forty-two orbits from 21 healthy subjects were used as controls. Complete ophthalmic examination and color Doppler flow imaging (CDFI) were performed before surgery and 3mo post-surgery on all 62 orbits from the TAO patients. CDFI were also performed on the 42 control orbits, The effect of OD +HCSE and OD alone on TAO orbits was compared on several endpoints, including superior ophthalmic vein blood flow (SOVBF) parameters, subjective assessment, soft tissue involvement, lid retraction, diplopia, eye movement restriction, degree of exophthalmos, and intraocular pressure. The control orbits were used as reference for the SOVBF parameters. RESULTS: OD surgery with or without HCSE improved SOVBF, symptoms and soft tissue involvement, decreased degree of exophthalmos and intraocular pressure in orbits of TAO patients. The OD +HCSE combination led to significantly better improvement of SOVBF than OD alone. The differences between the reductions of SOVBF in the two groups are 1.26 cmls in max-volecity and 0.52 cm/s in min-voiecity (P〈0.0001). CONCLUSION: SOVBF is significantly reduced in the orbits affected with TAO, indicating that congestion may be an important factor contributing to TAO pathogenesis. OD surgery improves the SOVBF, and combination of HCSE medication and OD surgery further improved venous return than OD surgery alone.
文摘目的探讨联合马栗树籽提取物治疗慢性盆腔疼痛综合征/下尿路症状(chronic pelvic pain syndrome/lower urinary tract symptoms,CPPS/LUTS)的临床效果。方法选取2017年9月至2019年9月山东大学齐鲁医院收治的CPPS/LUTS患者300例,患者服用药物治疗36个月后随访,收集有效病例220例,分为马栗树籽提取物组(60例)、α-受体阻滞剂组(70例)、马栗树籽提取物+α-受体阻滞剂组(90例)。通过慢性前列腺炎症状评分表(the national institutes of health chronic prostatitis symptom index,NIH-CPSI)各个因子的临床特征评判表来观察患者治疗前后的疼痛症状、排尿症状、症状严重程度以及患者生活质量等,观察治疗效果,并做治疗前后的回顾性研究。结果治疗后3组NIH-CPSI各因子分和总分均较治疗前减低,马栗树籽提取物+α-受体阻滞剂组显著降低,差异有统计学意义(P<0.001)。在疼痛症状方面,马栗树籽提取物组改善率为58.33%,α-受体阻滞剂组为28.57%,马栗树籽提取物+α-受体阻滞剂组为62.22%;在排尿症状方面,马栗树籽提取物组改善率为23.33%,α-受体阻滞剂组为64.29%,马栗树籽提取物+α-受体阻滞剂组为65.56%,差异有统计学意义(P<0.0167)。结论联合马栗树籽提取物对于CPPS/LUTS引起的疼痛、排尿、生活质量等有较好的缓解效果,并且能减轻症状的严重程度。